DHS内固定治疗股骨转子间骨折相关并发症临床分析  

Clinical Analysis of Postoperative Femeral Neck Nail Cutting-out after Treatment of Femeral Intertrochanteric Fractures with Dynamic Hip Screw

作　　者：徐华中[1] 施克勤[1] 朱国兴[1] 钱科军[1] 钱明权[1] 

机构地区：[1]无锡市第二人民医院骨科,江苏无锡214000

出　　处：《中国伤残医学》2012年第12期4-6,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨DHS治疗股骨转子间骨折发生螺钉切割股骨头并发症的原因。方法:2006年6月～2010年6月收治的股骨转子间骨折122例,行DHS内固定手术治疗。分析术后发生螺钉切割股骨头的原因。运用Harris评分评价髋关节功能恢复情况。结果:122例患者平均随访18个月(12～30月),术后髋关节Harris评分:良98例,中18例,差6例,其中优良率为95.1%。10例患者在术后1年内出现不同程度股骨颈螺钉切割股骨头,合并髋内翻畸形,其中行植骨手术2例,2例未处理,2例更换DHS内固定,同时原钉道自体植骨治疗,4例行人工关节置换术。结论:股骨转子间骨折行DHS钢板内固定要求良好的复位和固定;发生股骨颈螺钉切割股骨头与骨折粉碎程度、复位质量、螺钉放置位置,及股骨颈骨质质量等多种因素相关。Objective： To analyze cause for postoperative femeral neck nail cutting-out after treatment of femeral intertrochanteric fractures with DHS plate （DHS）.Methods： An retrospective study was done on 122 patients with intertrochanteric fractures treated with DHS plate from June 2006 to June 2010. The cause for postoperative femeral neck nail cutting-out were analyzed. Harris score was used to evaluate the functional recovery of the hip joint.Results： Of all, 122 patients were followed up for 12-30 months（mean 22 months）.According to Harris evaluation system , the results were excellent and good in 98 patients, fair in 18 and poor in 6.Postoperative femeral neck nail cutting-out in 10 patients, two of whom received reoperration to translate bone , two of whom received reopertion to fix with DHS plate and to translate bone;two of them received clinical observation whitout receiving reoperation, and other four patients received prosthetic replacement. Conclusion： Treatment of femeral intertrochanteric fractures with DHS plate requires good reduction and fixation of the fractures .Many factors including cortical bone conditions of httle trochanter, postoperative patients cognitive condition, use of improved Iensen-Evans classification and Singh＇s classification may affect operation outcome.

关 键 词：股骨转子间骨折 骨质疏松 动力髋螺钉 

分 类 号：R683[医药卫生—骨科学]